开发用于颌面创伤治疗的热响应复合骨板

Ilker Cengiz, Zeynep Caglar, Halil Murat Aydin
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摘要

对于严重外伤造成的面部骨折,可使用钢板和螺钉系统进行治疗。根据骨折的位置,将骨折线端对端,用钢板和螺钉固定。金属植入物有内源性感染的风险,而且在使用过程中会出现应力屏蔽现象、疼痛和局部刺激等固有问题。在骨愈合后,还需要进行第二次手术来移除金属固定物。考虑到这些问题,使用生物降解钢板代替金属钢板就显得尤为重要。生物降解骨折固定板在人体内降解缓慢,造成的疼痛和压力较小,而且无需进行第二次手术来移除合成材料。随着这些钢板的分解,负荷也会减少。可吸收植入体没有毒性和致突变作用。不过,使用这类植入体也存在一些问题,如炎症反应、植入体初始强度迅速下降、骨折率较高、植入体硬度不足以及与金属植入体相比较弱等。本研究设计了用于颌面骨损伤的生物降解板,并采用挤压和注射成型方法制备了治疗板。不同比例的碳酸三亚甲基酯(TMC)、聚 L-乳酸(LPLA)、聚 D,L-乳酸(DLPLA)、聚乙醇酸酯(PGA)和β-磷酸三钙(β-TCP)通过挤压混合,然后通过注射成型制成复合材料。获得了板材。研究了所得产品的降解、形态、热和机械性能。
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Development of thermally responsive composite bone plates for maxillofacial trauma treatment
Facial bone fractures in facial injuries resulting from severe trauma can be treated using plate and screw systems. Depending on the location of the fracture, the fracture lines are brought end to end and fixed with plates and screws. Metallic implants are at risk of endogenous infection and there are inherent problems associated with their use, such as stress shielding phenomena, pain, and local irritation. After the bone has healed, a second surgery is needed to remove the metallic fixation. Considering these problems, it is important to use biodegradable plates instead of metal plates. Biodegradable fracture fixation plates degrade slowly in the human body, causing less pain and stress, and there is no need for a second procedure to remove the synthetic material. As these plates decompose, the load will also decrease. There are no toxic and mutagenic effects in an absorbable implant. However, there are some problems with the use of these implants, such as inflammatory response, rapid loss of initial implant strength, higher fracture rates, insufficient hardness of the implants, and weakness compared to metallic implants. In this study, biodegradable plates were designed for use in maxillofacial bone injuries, and treatment plates were prepared using extrusion and injection molding. Different proportions of trimethylene carbonate (TMC), poly-L-lactate (LPLA), poly(D,L-lactate) (DLPLA), polyglycolate (PGA) and beta-tricalcium phosphate (β-TCP) are mixed by extrusion to produce composites by injection molding. Plates were obtained. The degradation, morphological, thermal, and mechanical behaviors of the obtained products were examined.
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